Because tuberculosis has resurfaced as a significant public health problem throughout Georgia, symposium participants proposed a new state-wide coalition to improve prevention, control and treatment. And since the risk of tuberculosis is greatest among disadvantaged populations, the participants emphasized that solutions must go beyond traditional medical models to involve a variety of health care providers, community organizations, representatives of at-risk populations and academics. A statewide program would ideally include a mandated statewide tracking system for tuberculosis cases. Participants also recommended strengthening regulations to enforce compliance, while recognizing the need to protect civil liberties.
The symposium was coordinated by Naomi Bock, assistant professor of medicine, and Randall Packard, director of Emory's Center for Health, Society and Culture.
Participants agreed that one of the most effective ways to combat the spread of TB is through involving members of the community in at-risk areas. The STARR (Street Teams for AIDS Risk Reduction) Team program, funded by the U.S. Centers for Disease Control and Prevention, was cited as an example of an effective use of community outreach workers.
Ronald Braithwaite, professor in the School of Public Health, is former director of the Morehouse School of Medicine's Health Promotion Resource Center, where he helped create 35 community-based coalitions to combat preventable illnesses within the black community.
Health is directly related to powerlessness and empowerment, Braithwaite pointed out. Poverty, lack of political control, chronic stress and lack of resources often lead to chronic disease. Creating coalitions that are community dominated encourages local "buy in" to prevention and treatment programs such as those needed to combat TB. These kinds of coalitions, however, require a "paradigm shift" in which health care professionals allow lay people not previously involved in health care decision making to play leadership roles.
Symposium participants concluded that partnership programs are the best way to maximize local resources and lead to more effective health initiatives. For example, violence was once thought of as a strictly criminal justice issuse; now it is widely recognized as a public health issue as well.
Margaret Parsons, associate professor in the School of Nursing, reminded participants about the great community coalitions built in Atlanta to combat tuberculosis in the first half of this century. Since no effective medical treatment was available at the time, care for TB patients and prevention involved women's groups, teachers, social workers, churches and businesses. The coalitions crossed lines of race, gender and socioeconomic groups. And although tuberculosis was the stimulus for these efforts, they went on to focus on health in general.
-- Holly Korschun